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The management of hepatic hemangioendothelioma (HHE) may be challenging. We aimed to review a large cohort of children who presented to our centers with symptomatic HHE in the last 16 years. We collected age at presentation, clinical features, histology, diagnostic process, management and outcome. Twenty seven patients (male/female 5/22), median age 13 days (1–1530) presented with hepatomegaly (24/27), cardiac failure (10/27), cutaneous hemangiomas (8/27), fever and anemia (6/27 each), vomiting (5/27), splenomegaly (4/27). The lesion was focal, multifocal, or diffuse in 9 patients of each group. The management included medical treatment (8/27), embolization (8/27), resection (3/27), observation (6/27), transplantation (2/27). After 16 months’ follow-up (30 days–11 years), 23/27 (85%) were alive. Diffuse lesions (4/4), cardiac failure (4/4), type II histology (4/4), age older than 6 months at diagnosis (3/4) predicted mortality (all p

Background Same-day discharge for percutaneous coronary interventions is an attractive and safe strategy. Observational and randomized data show equivalent results as compared to overnight observation. In addition, it ensues great savings for the healthcare system. Nevertheless, in Brazil, this approach is underused. The objective of this study was to describe the characteristics and outcomes of patients undergoing percutaneous coronary intervention with same-day discharge. Methods A single-center study with patients who underwent selected procedures, uneventful, discharged on the same day. Clinical and angiographic characteristics were described. Major cardiovascular events and complications were analyzed, reported, and compared to a historical cohort. Results A total of 413 patients were included, mean age of 64±10 years. After a 30-day follow-up, no major cardiovascular event was observed in selected patients submitted to the same-day discharge strategy. In addition, we found an increase in clinical and angiographic complexity as compared to the previous series, which did not translate to rise in adverse outcomes. Conclusion Uncomplicated percutaneous coronary interventions, with same-day discharge, are safe among appropriately selected patients, encouraging further adoption of this approach.

In patients with the obstructive variant of hypertrophic cardiomyopathy, when symptomatic despite the medical therapy, septal reduction is a common treatment option. Among all the percutaneous approaches, therapeutic septal alcoholization is the most commonly used technique. Non-alcoholic septal reduction techniques have recently emerged as an additional treatment option, generating procedures with more predictable outcomes and lower complication rates. In this report, we describe a case of therapeutic septal reduction with embolization of the target branch using coils with excellent immediate results.

Muscle strength, flexibility and changes in muscle recruitment patterns are usually associated to low back pain (LBP). Physical exercises can reverse the adverse changes associated to LBP.Compare Pilates, general exercises and educational workshop on muscle flexibility, strength and recruitment of the trunk extensor muscles in women with LBP.Forty-six women were randomly divided into Pilates group (PG, n = 16), general exercise group (GEG, n = 15), and educational group (EG, n = 15). This study sought to determine flexibility, muscle strength, and muscle recruitment of right (RIL), left (LIL) iliocostalis lumbar; right (RMU) and left (LMU) lumbar multifidus muscles. Both PG and GEG performed 16 exercise sessions, while EG attended 4 workshops. Statistical analysis used data sample from Shapiro-Wilk test, Pearson's correlation, multivariate analysis, mixed variance analysis, and Cohen's index.Flexibility showed no differences (p 0.05). Muscle strength increased in the intragroup analysis for PG (p = 0.003) and GEG (p = 0.002); however, the intergroup analysis presented no difference. Intergroup showed statistically significant differences for the recruitment of RMU in PG (p 0.001). Intragroup analysis presented differences after interventions in PG for RIL (p = 0.001); in GEG for LIL (p = 0.005); and in EG for RIL (p = 0.007), LIL (p = 0.002) and RMU (p 0.001).None of the groups showed flexibility improvements. PG and GEG increased muscle strength through intragroup analysis. Intergroup analysis showed an increase in recruitment of the RMU muscle in PG and all groups demonstrated significant improvements in the intragroup analysis.

Aldrovanda vesiculosa (Droseraceae) is a rare aquatic carnivorous plant, distributed in Europe, Asia, Africa, and Australia. Aldrovanda populations can flower prolifically under favourable conditions, but seed set is very limited. We studied the structure of Aldrovanda pollen collected from flowers in different developmental stages (opened and non-opened anthers) from both European and Australian populations to elucidate pollination traits and the basis of poor seed set on the basis of microscopic observation of pollen and anther structure. Microscopic analyses of Aldrovanda pollen showed that this plant has pollen arranged in tetrads like other species in the Droseraceae family. In hydrated pollen, cytoplasmic protrusions originate from pores located along the equatorial wall of monads, and can develop into pollen tubes. Interestingly, pollen development from microspores occurs in open anthers, suggesting a delay of the developmental stages. In addition, pollen development displays altered sperm cell formation and precocious pollen germination. Precocious germination may characterize recalcitrant pollen, which naturally do not undergo dehydration before anthesis and remain partially hydrated, particularly in aquatic and wetland plants. These alterations of male gametophyte development could affect fertilization processes, and be the reason for the low reproductive capability of Aldrovanda observed both in the field and in cultures. Generally, reduced pollen longevity and very quick germination are considered an adaptation to aquatic or wet environments.

Introduction: Soccer is the most played sport in the world and the one that causes more injuries. Imbalance between knee flexor and extensor is the main cause of muscle injuries in soccer players. Objective: The aim of this study was to verify the asymmetry and the correlation between the strength and flexibility of knee flexor and extensor as well as the difference of these variables between the right and left limbs in youth soccer players. Method: The sample consisted of 45 male youth soccer players for at least a year, aged between 13 and 16 years (14.7+0.86). The athletes underwent an assessment of flexibility of the posterior chain through the sit and reach test on Wells’ Bench and an assessment of flexibility of the quadriceps using the Ely’s test, with measurement of passive range of motion by goniometry. The peak of muscle strength was measured using a load cell (EMG  System, Brazil). Results: Data analysis showed difference between the values obtained in the Ely’s test of right and left leg (p=0,03), which did not happen for flexion strength (p=0.45), extension (p=0.41) and H:Q ratio (p = 0.40) when comparing the two members. It was observed a significant negative correlation between the H:Q ratio and the flexibility of the posterior chain test either for the right side (r=-0.40; p=0.006) or left side (r=-0.50; p=0.0004). Also a significant positive correlation was observed between quadriceps strength and flexibility of the posterior chain, both for the right (r=0.31; p=0.03) and the left side (r=0.32; p=0.02). Just for the left side a significant positive correlation was observed when compared the flexor muscle strength with the flexibility of the quadriceps (r=0.30; p=0.03). Conclusion: We conclude from this study that the flexibility of the posterior chain may be related to the strength of the antagonists, however, when the two physical qualities were compared in the same muscles, it showed no correlation.

Introduction: Given the intimate connection of the temporomandibular joint in the cervical region and its functions of chewing, speech and swallowing, patients with temporomandibular disorders (TMD) have most painful condition in stomathognatic muscles. Objective: Check for differences in pressure pain threshold of the masseter (MS), temporalis (TM), upper trapezius (UT) and sternocleidomastoid (SCM) muscles in different types of TMD. Method: Participated in the research 97 subjects, classified according to “The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)”: myofascial pain (TMD IA), myofascial pain with limited opening (TMD IB), disc displacement with reduction (TMD IIA), disc displacement without reduction and with limited opening (TMD IIB), disc displacement without reduction and without limited opening (TMD IIC). For measurement of the pressure pain threshold (PPT) was used the pressure algometry program (Kratos) of the TM, MS, UT and SCM muscles. For statistical analysis was used the Graphpad Instat program with the Kruskal-Wallis test. Results: The sample consisted of 67 women and 30 men with an average age of 22.09 ± 5.45 years. Of these subjects, 40 were classified as “with TMD”, 57 as “without TMD”, 34 as “TMD IA”, 16 as “TMD IB”, 14 as “TMD IIA” and nobody as “TMD IIB” and “TMD IIC”. The MS, TM and UT muscles showed decreased threshold in myogenic groups of TMD with relation to the group without TMD. Only the masseter muscle showed statistical significance when compared to the myogenic groups with each other, demonstrating that the IB group has lower PPT. Individuals with TMD IB showed lower PPT of MS, TM and UT muscles when compared to TMD IIA. Conclusion: There is a significant difference comparing the PTT of MS, TM and UT muscles of myofascial pain subgroup to the subgroup without TMD. There were differences between the groups myogenic in PPT of MS. TMD IB showed lower threshold in TMD IB group than in TMD IIA group. Controversially, it was not observed when comparing the SCM muscle and disc displacement subgroup with the subgroup without TMD.

Contains fulltext : 229846.pdf (Publisher’s version ) (Closed access) BACKGROUND: Early reports on patients with cancer and COVID-19 have suggested a high mortality rate compared with the general population. Patients with thoracic malignancies are thought to be particularly susceptible to COVID-19 given their older age, smoking habits, and pre-existing cardiopulmonary comorbidities, in addition to cancer treatments. We aimed to study the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with thoracic malignancies. METHODS: The Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) registry is a multicentre observational study composed of a cross-sectional component and a longitudinal cohort component. Eligibility criteria were the presence of any thoracic cancer (non-small-cell lung cancer [NSCLC], small-cell lung cancer, mesothelioma, thymic epithelial tumours, and other pulmonary neuroendocrine neoplasms) and a COVID-19 diagnosis, either laboratory confirmed with RT-PCR, suspected with symptoms and contacts, or radiologically suspected cases with lung imaging features consistent with COVID-19 pneumonia and symptoms. Patients of any age, sex, histology, or stage were considered eligible, including those in active treatment and clinical follow-up. Clinical data were extracted from medical records of consecutive patients from Jan 1, 2020, and will be collected until the end of pandemic declared by WHO. Data on demographics, oncological history and comorbidities, COVID-19 diagnosis, and course of illness and clinical outcomes were collected. Associations between demographic or clinical characteristics and outcomes were measured with odds ratios (ORs) with 95% CIs using univariable and multivariable logistic regression, with sex, age, smoking status, hypertension, and chronic obstructive pulmonary disease included in multivariable analysis. This is a preliminary analysis of the first 200 patients. The registry continues to accept new sites and patient data. FINDINGS: Between March 26 and April 12, 2020, 200 patients with COVID-19 and thoracic cancers from eight countries were identified and included in the TERAVOLT registry; median age was 68.0 years (61.8-75.0) and the majority had an Eastern Cooperative Oncology Group performance status of 0-1 (142 [72%] of 196 patients), were current or former smokers (159 [81%] of 196), had non-small-cell lung cancer (151 [76%] of 200), and were on therapy at the time of COVID-19 diagnosis (147 [74%] of 199), with 112 (57%) of 197 on first-line treatment. 152 (76%) patients were hospitalised and 66 (33%) died. 13 (10%) of 134 patients who met criteria for ICU admission were admitted to ICU; the remaining 121 were hospitalised, but were not admitted to ICU. Univariable analyses revealed that being older than 65 years (OR 1.88, 95% 1.00-3.62), being a current or former smoker (4.24, 1.70-12.95), receiving treatment with chemotherapy alone (2.54, 1.09-6.11), and the presence of any comorbidities (2.65, 1.09-7.46) were associated with increased risk of death. However, in multivariable analysis, only smoking history (OR 3.18, 95% CI 1.11-9.06) was associated with increased risk of death. INTERPRETATION: With an ongoing global pandemic of COVID-19, our data suggest high mortality and low admission to intensive care in patients with thoracic cancer. Whether mortality could be reduced with treatment in intensive care remains to be determined. With improved cancer therapeutic options, access to intensive care should be discussed in a multidisciplinary setting based on cancer specific mortality and patients' preference. FUNDING: None.

The TANDEM investigation was carried out in 17 Italian Movement Disorder centers on behalf of a joint initiative of neurologist members of the Italian Academy for Parkinson’s disease and Movement Disorders (LIMPE-DISMOV Academy) and gastroenterologist members of the Italian Society of Digestive Endoscopy (SIED) to evaluate the efficacy and tolerability of levodopa-carbidopa intestinal gel (LCIG) in patients with advanced Parkinson's disease (PD) in routine medical care. Motor scores in “ON” and OFF” state (UPDRS-III), complications of therapy (UPDRS-IV), activities of daily living, sleep disorders and quality of life were evaluated at baseline and at two follow-up assessments (FUV1 and FUV2) within the initial 12-month LCIG treatment. In 159 patients (55% males) with a mean age of 69.1 ± 6.6years and a diagnosis of PD since 13.6 ± 5.5years, the UPDRS-III total score (in “OFF”) decreased from baseline (45.8 ± 13.2) to FUV1 (41.0 ± 17.4; p < 0.001) and FUV2 (40.5 ± 15.5; p < 0.001), the UPDRS-IV total score decreased from baseline (8.8 ± 2.9) to FUV1 (5.1 ± 3.4; p < 0.001) and FUV2 (5.5 ± 3.2; p < 0.001). The percentage of patients exhibiting freezing, dystonia, gait/walking disturbances, falls, pain and sleep disorders was significantly reduced. Twenty-eight device complications were reported and 11 (6.9%) patients prematurely terminated the study. LCIG after 12-month treatment led to sustained improvement of time spent in “OFF”, complications of therapy, PD-associated symptoms and sleep disorders. LCIG tolerability was consistent with the established safety profile of LCIG.

Introducao Arterite de celulas gigantes ou arterite temporal e a arterite de grandes vasos mais comum em paises ocidentais, acometendo geralmente pacientes acima de 50 anos. Na maioria dos casos sintomas cranianos estao presentes, no entanto, manifestacao exclusivamente extracranianas pode ocorrer em ate 22% dos casos. O envolvimento aortico e de outros grandes vasos (carotidas, subclavias) e frequente neste contexto. Observa-se acometimento da adventicia da arteria principalmente por ativacao de celulas dendriticas gerando processo inflamatorio granulomatoso em focos multiplos com [...]

Luigi Cavanna,1 Elisa Maria Stroppa,1 Chiara Citterio,1 Patrizia Mordenti,1 Camilla Di Nunzio,1 Silvia Peveri,2 Elena Orlandi,1 Stefano Vecchia31Oncology and Hematology Department, Oncology Unit, Piacenza General Hospital, Piacenza, Italy; 2Allergology and Statistics Unit, Piacenza General Hospital, Piacenza, Italy; 3Pharmacy Unit, Piacenza General Hospital, Piacenza, ItalyPurpose: Metastatic pancreatic adenocarcinoma has a very poor prognosis. Although irinotecan, oxaliplatin and leucovorin-modulated fluorouracil (FOLFIRINOX) significantly increases survival in advanced pancreatic cancer, compared to employing only gemcitabine (GEM), toxicities have tempered enthusiasm for its use.Methods: This study retrospectively analyses the real-world clinical practice with full and attenuated doses of FOLFIRINOX in unselected patients with locally advanced unresectable or metastatic pancreatic cancer, treated at an Italian general hospital. Efficacy, tolerability, and toxicity were evaluated, and overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan–Meier method.Results: Fifty consecutive patients with advanced (13) or metastatic (37) pancreatic adenocarcinomas were treated with FOLFIRINOX at the Medical Oncology Unit, Piacenza General Hospital, North Italy. The first enrolled consecutive 18 patients (36%) of this series started the treatment with a full dose of the regimen, while the subsequent 32 (64%) consecutive patients received dose attenuation (−20% bolus fluorouracil and −25% irinotecan). In the entire group, the response rate, median OS, and median PFS were 30%, 10.1 months, and 5.6 months, respectively, with no differences in objective response in the 32 patients that received an attenuated dose compared with the 18 patients receiving a full dose of chemotherapy. However, neutropenia, anemia, fatigue, and vomiting were statistically increased in the 18 patients receiving a full dose compared with the 32 patients receiving an attenuated dose of FOLFIRINOX (p

Apgar Score (AS) 5min 5min 5min 5min ≥ 7). AS5min Conclusion: AS5min was associated with maternal, obstetric, anthropometric, and postnatal variables of neonates admitted to the NICU. Specific maternal and postnatal variables interfered with the survival of these newborns.

Background & Aim: An endoscopic classification of Diverticular Disease (DD), called DICA (Diverticular Inflammation and Complication Assessment) is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement levels for this classification among an endoscopist community setting.Methods: A total of 66 endoscopists independently scored a set of DD endoscopic videos. The percentages of overall agreement on the DICA score and a free-marginal multirater kappa (κ) coefficient were reported as statistical measures of the inter-rater agreement.Results: The overall agreement levels were: 70.2% for DICA 1, 70.5% for DICA 2, 81.3% for DICA 3. The free marginal κ was: 0.553 for DICA 1, 0.558 for DICA 2, 0.719 for DICA 3. The agreement levels among the expert group were: 78.8% for DICA 1, 80.2% for DICA 2, 88.5% for DICA 3. The free marginal κ among the expert group were: 0.682 for DICA 1, 0.712 for DICA 2, 0.828 for DICA 3. The agreement of expert raters on the single item of the DICA classification was superior to the agreement of the overall group.Conclusions: The overall inter-rater agreement for DICA score in this study ranges from moderate to good, with a significant improvement in the expert subgroup of raters. Diverticular Inflammation and Complication Assessment is a simple and reproducible endoscopic scoring system.

Made available in DSpace on 2021-06-25T19:36:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-06-01 Objective: The purpose of this study was to evaluate the effects of plantar myofascial mobilization (PMM) on the plantar area, balance, and functional mobility of elderly women. Methods: In this randomized, single-blind, placebo-controlled clinical trial, elderly women with maintained independent orthostatism were recruited from the community and randomly separated into a PMM group (MG = 15), a placebo group (PG = 13), or a control group (control group = 14). Vigorous PMM and soft PMM were performed in the MG and PG, respectively, for 5 days with a rest day between each. The measures of plantar area, single leg stance test with open eye and closed eye, and timed up-and-go test were performed pre-PMM, immediately post-PMM, and on the last day of the protocol. The control group only underwent evaluation before and on the last day of the protocol. The sample size was calculated, and, for quantitative variables, a mixed analysis of variance was used for repeated measurements (split plot), followed by the Bonferroni post hoc test. The results were analyzed in 2 ways: 3 groups at 2 moments (pre, last day), and 2 groups at 3 moments (pre, post, last day). Results: Forty-two elderly women with mean age of 69.03 +/- 3.32 years were included in the study. The vigorous MMP showed a statistically significant increase in the plantar area of the right foot (3 groups: P = .49) and single leg stance test with open eye time (2 groups: P = .002; 3 groups: P = .001), and a decrease in the timed up-and-go time (2 groups: P = .04; 3 groups: P = .0001). Conclusion: The vigorous PMM showed increases of the plantar area and promoted beneficial effects on functional mobility and body balance. Sao Paulo State Univ, Dept Phys Therapy & Occupat Therapy, Marilia, SP, Brazil Fed Univ, Fac Phys Therapy & Occupat Therapy, Hlth Sci Inst, Belem, Para, Brazil Univ Marilia, Dept Phys Educ, Marilia, SP, Brazil Sao Paulo State Univ, Dept Phys Therapy & Occupat Therapy, Marilia, SP, Brazil

Background: We describe cancer patients with coronavirus disease-2019 (COVID-19) infection treated at the Piacenza’s general hospital (north Italy). Materials & methods: 25 cancer patients infected by COVID-19 admitted at the Piacenza’s general hospital from 21 February to 18 March 2020. Outcome from the infection were compared with infected noncancer patients. Results: 20 patients (80%) were treated with antiviral therapy and hydroxychloroquine and five (20%) received hydroxychloroquine alone. Nine (36%) patients died, while 16 (64%) overcome the infection. In the control group the mortality was 16.13% and the overcome from infection was 83.87%. Conclusion: Mortality for COVID-19 was greater in cancer patients when compared with noncancer patients, worse prognosis for older age, women and patients treated with hydroxychloroquine alone. However, the comparisons did not reach statistical significance in most cases. This could be due to the small sample size that is the main limitation of the study.

Made available in DSpace on 2020-12-12T01:58:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-04-01 ASCRS Research Foundation Safe street crossing is important for older adults' social inclusion. We assessed gait kinematic adaptation under different simulated street crossing conditions in older adults with Parkinson's disease (PD) and made comparisons with older adults without PD to understand how PD interferes in outdoor task performance, helping in the development of strategies to reduce road traffic accident risk. In 20 older adults without PD (control group – CG) and 20 with PD (GPD), we assessed usual gait (C1), gait during street crossing simulation (C2), and gait during reduced-time street crossing simulation (C3). Velocity, step length, and step, swing, stance, and double support time were analyzed. Spatiotemporal differences in gait between groups and conditions were analyzed. The GPD walked 16% slower in C1 and 12% slower in C2 and C3 than the CG. GPD also took 11% shorter steps in C1 and 9.5% shorter steps in C2. The double support time was 8.5% greater in C1. In intragroup comparisons, there were significant differences in all gait conditions. The CG showed increased velocity (C2 15% > C1; C3 13% > C2; C3 26% > C1), step length (C2 8% > C1; C3 5% > C2; C3 13% > C1), and swing time (C2 2% > C1; C3 3.7% > C2; C3 6% > C1), and decreased step time (C2 7.5% < C1; C3 8% < C2; C3 15% < C1), stance time (C2 1.3% < C1; C3 2.5% < C2; C3 3.6% < C1), and double support time (C2 6.3% < C1; C3 10.5% < C2; C3 16% < C1). GPD showed increased velocity (C2 19% > C1; C3 13.5% > C2; C3 29.7% > C1), step length, (C2 6% > C1; C3 7% > C2; C3 16% > C1), and swing time (C2 3% > C1; C3 3% > C2; C3 5.5% > C1) and decreased step time (C2 10.3% < C1; C3 7.7% < C2; C3 17% < C1), stance time (C2 1.7% < C1; C3 1.7% < C2; C3 3.4% < C1), and double support time (C2 7% < C1; C3 9.5% < C2; C3 16% < C1). Kinematic changes observed in the intergroup comparison show that participants with PD had lower velocity in all conditions. However, per the intragroup results, both participants with and without PD managed to significantly modify gait variables to attempt to cross the street in the given time. It is necessary to assess whether this increases fall risk by exposing them to road traffic accidents. Institute of Biosciences São Paulo State University (UNESP), Avenida vinte e quatro A, 1515 Faculty Anhanguera of Jundiaí Rua do Retiro 3000 Faculty of Higher Education of Interior São Paulo (FAIP), Avenida Antonieta Altenfelder, 65 Laboratory of Assessment and Rehabilitation of Equilibrium Department of Biomechanics Medicine and Rehabilitation of the Locomotor System School of Medicine of Ribeirão Preto University of São Paulo, Avenida Bandeirantes, 3900 Faculty of Physical Education and Physiotherapy Federal University of Amazonas, Avenida General Rodrigo Octavio Jordão Ramos, 1200 Department of Physical Therapy and Occupational Therapy School of Philosophy and Science São Paulo State University (UNESP), Avenida Hygino Muzzi FIlho, 737 Institute of Biosciences São Paulo State University (UNESP), Avenida vinte e quatro A, 1515 Department of Physical Therapy and Occupational Therapy School of Philosophy and Science São Paulo State University (UNESP), Avenida Hygino Muzzi FIlho, 737 ASCRS Research Foundation: 2012/01770-1

Background. Splenic infarction is a rare clinical condition. It is generally attributed to hematologic, vascular, cardioembolic, and infectious diseases or trauma. Case Presentation. We describe a rare case in an otherwise asymptomatic 41-year-old overweight woman with acute abdominal pain. Imaging work-up revealed splenic infarction. Common etiologies were excluded. A transesophageal echocardiography (TEE) revealed a patent foramen ovale (PFO). The patient was sent to closure with good outcome. Conclusion. Paradoxical embolism due to PFO can be a cause of splenic infarction, and its investigation and subsequent closure may be considered when there are no other causative disorders.

Introduction: The lumbar pain is the main musculoskeletal complaint reported by the active population, and it prevents daily activities such as walking. Objective: To assess muscle recruitment and the co-contraction of the trunk muscles during different walking speed in individuals with and without chronic lumbar pain. Method: Thirty-four sedentary young women attended the study, in which 18 belonged to the lumbar pain team (LPT) and 16 to the team without lumbar pain (WLP). We assessed the electromyography activity of the internal oblique (IO) local muscle and lumbar multifidus (MUL), and global external oblique (EO), abdominal rectus (AR) and lumbar iliocostalis (LIC), during walking. The electromyography analysis was performed from the average of the linear envelope value, normalized by the peak of muscle activation. The muscle co-contraction (IO/MUL, EO/LIC, AR/LIC, IO/EO, and the abdominal/paravertebral muscle groups) was calculated with the Falconer and Winter formula. The Shapiro-Wilk test, Multivariate Analysis, mixed Variance Analyses with Bonferroni post-hoc, and Pearson (p < 0.05) correlation coefficient were made by the statistical analysis. Results: In the WLP we could notice that the higher the speed, the higher the MUL activation. The co-contraction data demonstrated that IO/MUL muscles activate 20% more in the LPT, during the preferred speed; however, in the WLP, the results showed that the higher the walking speed, the higher the EO/LIC (21.8%) and IO/MUL (17.8%) muscles activation. Conclusion: The recruitment of local muscles doesn’t differ among the evaluated groups and conditions; however, in WLP, the higher the MUL muscle action, the higher the walking speed. Resumo Introdução: A dor lombar (DL) é a principal queixa musculoesquelética relatada na população ativa e incapacita atividades do cotidiano, como a marcha. Objetivo: Avaliar o recrutamento e co-contração dos músculos do tronco durante diferentes velocidades de marcha em indivíduos com e sem DL crônica. Método: Participaram 34 mulheres jovens, sedentárias, 18 compuseram o grupo DL (GDL) e 16 o grupo sem DL (GC). Foi avaliada a atividade eletromiográfica dos músculos locais oblíquo interno (OI) e multífido lombar (MUL), e globais oblíquo externo (OE), reto abdominal (RA) e iliocostal lombar (ICL), durante a marcha. A análise eletromiográfica foi realizada a partir da média do valor de envelope linear, normalizada pelo pico de ativação muscular. A co-contração muscular (OI/MUL, OE/ICL, RA/ICL, OI/OE e os grupos musculares abdominais/ paravertebrais) foi calculada com a fórmula de Falconer e Winter. A análise estatística foi feita por meio do teste Shapiro-Wilk, Análise Multivariada, Análise de Variância mista com pos-hoc bonferroni e coeficiente de correlação de Pearson (p < 0,05). Resultados: No GC podemos perceber que, quanto maior a velocidade, maior a ativação do MUL. Os dados de co-contração demonstraram que os músculos OI/MUL ativam 20% a mais no GDL, durante a velocidade de preferência, no GC, os resultados mostram que quanto maior a velocidade de marcha, maior a ativação dos músculos OE/ICL (21,8%) e OI/MUL (17,8%). Conclusão: O recrutamento dos músculos não difere entre os grupos e condições, contudo foi observado no GC que quanto maior a ação do músculo MUL maior é a velocidade de marcha. Resumen Introducción: El dolor lumbar (DL) es la principal queja musculoesquelética relatada e incapacita actividades de lo cotidiano, como la marcha. Objetivo: Evaluar el reclutamiento y la co-contracción músculos del tronco durante diferentes velocidades de marcha en individuos con y sin DL. Método: Participaron 34 mujeres jóvenes, sedentarias, 18 compusieron grupo DL (GDL) y 16 grupo sin DL (GC). Se evaluó la actividad electromiográfica de los músculos oblicuo interno (OI) y externos (OE), multífido lumbar (MUL), recto abdominal (RA) e iliocostal lumbar (ICL) durante la marcha. El análisis electromiográfico fue realizado a partir del promedio del valor de sobre lineal, normalizado por el pico de activación muscular. La cocontracción muscular (OI/MUL, OE/ICL, RA/ICL, OI/OE y grupos de músculos abdominales/paravertebrales) se calculó utilizando la fórmula Falconer y Winter. El análisis estadístico fue realizado por Shapiro-Wilk, Análisis Multivariado, Análisis de Variedad mixta con pos-hoc bonferroni y coeficiente de correlación de Pearson (p < 0,05). Resultados: En el GC podemos percibir que, cuanto mayor es la velocidad, mayor es la activación del MUL. Los datos de co-contracción demostraron que los músculos OI/MUL activan un 20% más en el GDL, durante la velocidad de preferencia, sin embargo, en el GC, los resultados muestran que cuanto mayor la velocidad de marcha, mayor la activación de los músculos OE / ICL (21,8%) y OI/MUL (17,8%). Conclusión: El reclutamiento de los músculos no difiere entre los grupos y condiciones, contenido observado en el GC que cuanto mayor es la acción del músculo MUL mayor es la velocidad de marcha.

Introduction: Chronic low back pain (CLBP) presents neuromuscular dysfunctions, per example, the reduction of muscle strength and endurance. They are essential in performing tasks and postural maintenance. Objective: This study was to characterize the muscle strength and endurance. It checked the discriminant variables to CLBP population. Methods: 35 sedentary young females aged 18 to 27 years old. They were assessed and divided in with CLBP (n=18) and a without LBP (n=17). The assessment included the measurement of pain level (Visual Analogue Scale), isometric strength of trunk extensor muscles (Lumbar Dynamometer) and static endurance of trunk extensors muscles (Biering-Sorensen Test). A Multivariate Analysis of Variance and a Discriminant Analysis were performed adopting a 5% level of relevance. Results: The group with CLBP presented decrease muscle strength (21%; p=0.01) and endurance (71%, p

To contribute to a better understanding of the molecular bases of the circadian biological rhythms in Chagas disease vectors, in this work we identified functional domains in the sequences of the clock protein PERIOD (PER) in Rhodnius prolixus and Triatoma infestans and analyzed the expression of the PER gene at mRNA level in T. infestans. The PER protein sequences comparison among these species and those from other insects revealed that the most similar regions are the PAS domains and the most variable is the COOH-terminal. On the other hand, the per gene expression in nervous tissue of adult T. infestans varies with a daily canonical rhythm in groups of individuals maintained under photoperiod (light/dark, LD) and constant dark (DD), showing a significant peak of expression at sunset. The pattern of expression detected in LD persists under the DD condition. As expected, in the group maintained in constant light (LL), no daily increase was detected in per transcript level. Besides, the presence of per transcript in different tissues of adult individuals and in nervous tissue of nymphs evidenced activity of peripheral clocks in adults and activity of the central clock in nymphs of T. infestans. Fil: Stroppa, Maria Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina Fil: Gimenez, Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina Fil: Garcia, Beatriz Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina

Introduction: Individuals with glomerular filtration rate (GFR) ≥60 ml/min/1.73 m2 estimated by the Cockcroft-Gault formula (CG) who undergo percutaneous coronary intervention (PCI) frequently develop contrast-induced nephropathy (CIN). This study aimed to assess whether individuals with significant renal impairment assessed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, but not by CG, more often develop CIN following PCI than those without renal impairment by either formula. Methods: In this cross-sectional study analyzing patients with baseline CG GFR ≥60 ml/min/1.73 m2 before PCI, subjects were divided into two groups according to CIN occurrence. Baseline CKD-EPI GFR was calculated for all patients. Results: We analyzed 140 patients. Baseline GFR was 87.5±21.3 and 77.1±15.0 ml/min/1.73 m2 for CG and CKD-EPI, respectively. CIN occurred in 84.6% of individuals with baseline CKD-EPI GFR

Malaria remains one of the most important parasitic diseases in the world. The multidrug-resistant Plasmodium strains make the treatment currently available for malaria less effective. Therefore, the development of new drugs is necessary to overcome therapy resistance. Triazole derivatives exhibit several biological activities and provide a moiety that is promising from the biological perspective. Due to the structural similarity to NADH, it is believed that triazoles can bind to the active site of the Plasmodium lactate dehydrogenase (pLDH) enzyme. The present work evaluates the antimalarial activity of 1,2,3-triazole derivatives by in silico, in vitro, and in vivo studies. Preliminary in silico ADMET studies of the compounds demonstrated good pharmacokinetic properties. In silico docking analysis against LDH of Plasmodium berghei (PbLDH) showed that all compounds presented interactions with the catalytic residue in the active site and affinity similar to that presented by chloroquine; the most common antimalarial drug. Cytotoxicity and hemolysis by these derivatives were evaluated in vitro. The compounds 1, 2, 5, 8, and 9 proved to be non-cytotoxic in the performed tests. In vivo antimalarial activity was evaluated using mice infected with Plasmodium berghei NK65. The five compounds tested exhibited antimalarial activity until nine days post-infection. The compound 5 showed promising activities, with about 70% parasitemia suppression. Considering the in vitro and in vivo studies, we believe the compound 5 to be the most promising molecule for further studies in antimalarial chemotherapy.

Dentes natais são dentes presentes na cavidade bucal ao nascimento. Essa desordem pode acarretar alguns problemas para o recém-nascido, como doença de Riga-Fede, risco de aspiração e deglutição do elemento dental, bem como lesões no seio materno durante a amamentação. O objetivo deste trabalho foi relatar o caso clínico de um paciente de quatro dias de vida, levado à Clínica de Odontopediatria da Universidade Positivo por sua mãe, a qual se queixava da presença de um dente na região anterior inferior da boca da criança. Ao exame clínico, observou-se a presença de um dente natal na região dos incisivos centrais inferiores. O tratamento realizado consistiu em exodontia do elemento 81, devido ao elevado grau mobilidade e risco de aspiração pelo bebê. A decisão terapêutica deve levar em consideração alguns fatores importantes, como os níveis de implantação e mobilidade do dente natal, os quais podem gerar complicações e riscos à saúde do bebê.

Here, we report the effect of new non-classical bioisosteres of miltefosine on Leishmania amazonensis. Fifteen compounds were synthesized and the compound dhmtAc, containing an acetate anion, a side chain of 10 carbon atoms linked to N-1 and a methyl group linked to N-3, showed high and selective biological activity against L. amazonensis. On the intracellular amastigotes, stages of the parasite related to human disease, the IC50 values were near or similar to the 1.0μM (0.9, 0.8 and 1.0μM on L. amazonensis-WT, and two transgenic L. amazonensis expressing GFP and RFP, respectively), being more active than miltefosine. Furthermore, dhmtAc did not show toxic effects on human erythrocytes and macrophages (CC50=115.9μM) being more destructive to the intracellular parasites (selectivity index>115). Promastigotes and intramacrophage amastigotes treated with dhmtAc showed low capacity for reversion of the effect of the compound. A study of the mechanism of action of this compound showed some features of metazoan apoptosis, including cell volume decreases, loss of mitochondrial membrane potential, ROS production, an increase in the intracellular lipid bodies, in situ labeling of DNA fragments by TUNEL labeling and phosphatidylserine exposure to the outerleaflet of the plasma membrane. In addition, the plasma membrane disruption, revealed by PI labeling, suggests cell death by necrosis. No increase in autophagic vacuoles formation in treated promastigotes was observed. Taken together, the data indicate that the bioisostere of miltefosine, dhmtAc, has promising antileishmanial activity that is mediated via apoptosis and necrosis.

A chromatographic method by HPAEC-PAD was developed and in-house validated for the quantification of low sugar levels in hard cheese, specifically Grana Padano PDO cheese. Particular attention was paid to the extraction procedure, due to residual microbial and enzymatic activities. Specificity in detection and linearity were verified. Recoveries ranged from 93% for lactose to 98% for glucose and galactose. The obtained LOD and LOQ values were, respectively, 0.25 and 0.41mg/100g for lactose, 0.14 and 0.27mg/100g for galactose, and 0.16 and 0.26mg/100g for glucose. The method was applied to 59 samples of Grana Padano PDO cheese: galactose showed the highest concentration and variability among the samples (1.36±0.89), compared to both lactose (0.45±0.12) and glucose (0.46±0.13). Considering the very low levels of sugars detected, authentic PDO Grana Padano could be safely included in the diet of people suffering from lactose intolerance.

To contribute to a better understanding of the molecular basis of the circadian biological rhythms in Chagas disease vectors, in this work we identified functional domains in the sequences of the clock protein TIMELESS (TIM) in Rhodnius prolixus and analyzed the expression of the timeless (tim) gene at the mRNA level in Triatoma infestans. The tim gene expression in nervous tissue of adult T. infestans revealed clear oscillations in the abundance of the transcript in both sexes in the group maintained under photoperiod with a daily canonical rhythm, showing a significant increase in expression at sunset. As expected, in the group maintained in constant light, no daily increase was detected in the tim transcript level. Fil: Stroppa, Maria Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina. Universidad Nacional de Córdoba. Facultad de Medicina. Cátedra de Bioquímica y Biología Molecular; Argentina Fil: Garcia, Beatriz Alicia. Universidad Nacional de Córdoba. Facultad de Medicina. Cátedra de Bioquímica y Biología Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina

Background: Delirium is a common and potentially preventable condition in older individuals admitted to acute and intensive care wards, associated with negative prognostic effects. Its clinical relevance is being increasingly recognised also in cardiology settings. The aim of the present study was to assess the prevalence, incidence, predictors and prognostic role of delirium in older individuals admitted to two cardiology intensive care units. Methods: All patients aged over 65 years consecutively admitted to the two participating cardiology intensive care units were enrolled. Assessment on admission included acute physiological derangement (modified rapid emergency medicine score, REMS), chronic comorbidity, premorbid disability and dementia. The Confusion Assessment Method–Intensive Care Unit was applied daily for delirium detection. Results: Of 497 patients (40% women, mean age 79 years), 18% had delirium over the entire cardiology intensive care unit course, half of whom more than 24 hours after admission (incident delirium). Advanced age, a main diagnosis of ST-segment elevation myocardial infarction or acute respiratory failure, modified REMS, comorbidity and dementia were independent predictors of delirium. Adjusting for patient’s features on admission, incident delirium was predicted by invasive procedures (insertion of peripheral arterial catheter, urinary catheter, central venous catheter, naso-gastric tube and intra-aortic balloon pump). In a logistic regression model, delirium was an independent predictor of inhospital mortality (odds ratio 3.18, 95% confidence interval 1.02, 9.93). Conclusions: Eighteen per cent of older cardiology intensive care unit patients had delirium, with half of the cases being incident, thus potentially preventable. Invasive procedures were independently associated with incident delirium. Delirium was an independent predictor of inhospital mortality. Awareness of delirium should be increased in the cardiology intensive care unit setting and prevention studies are warranted.

Aim To compare the soft tissue stability (STA) around single implants previously augmented with either subepithelial connective tissue graft (SCTG) from the lateral palate (LP) or from the tuberosity area (TA). Material and methods Twenty-nine patients showing 33 implants with buccal volume deficiency randomly received SCTG from LP (control group/CG) or TA (test group/TG). At 4 months (FU-4) the definitive crown was installed and an intra-oral scan performed. At 12 months (FU-12), a new scan was registered. Between FU-4 and FU-12 STA was evaluated by STL image superimposition. Clinical parameters and the modified pink aesthetic score (PES) (Furhauser et al. 2005) were recorded. Results After FU-4 both tissues demonstrated a similar STA without statistically significant differences (SSD). The mean soft tissue changes were 0.03 ± 0.22 mm for CG and 0.04 ± 0.23 mm for TG (p = .870). SSD were observed for changes in keratinized tissue (KT) with greater stability for TG (0 ± 0.32 mm) compared with CG (-0.3 ± 0.33 mm) (p = .002). PES resulted in mean values of 8.37 ± 2.46 for CG and 8.54 ± 2.43 for TG (p=.59). Conclusions Both groups demonstrated similar STA between the definitive crown placement and 12 months, while greater stability of the KT gained was observed in TG.

Background Purulent pericarditis is an unusual first manifestation of HIV-infected patients. Co-infections in this scenario are possible and challenging. Mycobacterium tuberculosis is a frequent agent in purulent pericarditis related to HIV infection but co-infection with Staphylococcus aureus is rarely reported. Case presentation We describe a rare case in otherwise asymptomatic 39-year-old diabetic man with acute purulent pericarditis leading to tamponade due to S. aureus and evidences of M. tuberculosis co-infection. Testing for human immunodeficiency virus was positive. Conclusion Primary purulent pericarditis is a rare condition and may indicate underlying HIV infection. In this scenario, coinfection with multiple organisms are possible and patient should be tested for underlying tuberculosis in addition to standard microbiological workup.

BACKGROUND: Most pediatric liver transplantation (LT) centers administer long courses of prophylaxis against cytomegalovirus (CMV) without evidence of benefit and with significant drug exposure and costs. We aimed at evaluating overall outcomes, direct and putative indirect effects of CMV, possible impact of viremia and risk factors for CMV infection in pediatric LT recipients managed with ganciclovir-based preemptive therapy (PET). METHODS: The records of all the children who underwent LT between 2008 and 2014 were retrospectively analyzed. RESULTS: One hundred children were included. Three children had CMV disease; no CMV-related death or graft loss was recorded. The only identified risk factor for CMV infection was the donor/recipient serostatus (odds ratio, 17.23; 95% confidence interval, 1.88-157.87; P = 0.012), while viremia per se did not worsen LT outcomes, such as the incidence of acute rejection, Epstein-Barr virus infection, sepsis, biliary and vascular complications, nor graft dysfunction/loss or death at 3 and 5 years after LT. When compared with a historical cohort of children receiving ganciclovir prophylaxis, PET did not differ from prophylaxis for any of the selected outcomes, but was rather associated with lower antiviral drug exposure (6.4 ± 13 days vs 38.6 ± 14 days, P < 0.0001) and cost per patient (2.2 ± 3.9 k€ vs 6.6 ± 8.2 k€, P = 0.001). CONCLUSIONS: PET is effective in controlling CMV in children receiving LT, with lower costs and lower exposure to antivirals.

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This study aimed to report the case of an eight-year-old patient with cleft lip and palate associated with undiagnosed syndrome presenting high level of carious lesions, difficulty on oral hygiene, no collaborative behavior and cariogenic diet. Case report: The patient underwent outpatient treatment for dental extraction and Atraumatic Restorative Treatment. Later at the following-up appointment, the child presented new active white spots and fractured restorations. Then, dental treatment under general anesthesia for amalgam restorations was indicated. Conclusion: We conclude that dental care under general anesthesia was an alternative treatment for the reported child in this clinical case that had a high prevalence of caries, cariogenic diet, loss of lip elasticity due to corrective surgeries, difficult access for oral hygiene and caregiver’s fear to toothbrush near to the cleft.

Made available in DSpace on 2020-12-12T01:57:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-04-01 Introduction: Although it is known that individuals with Parkinson's disease (PD) have difficulties performing dual-task activities, most of the studies have verified the effect of dual tasks on gait using tasks that are uncommon to perform while walking. However, the realization of tasks involving gait that really represents the daily activities carried out by the participants, allow us to detect real fall risk situations of individuals with PD during their gait. Objective: Our aim was to verify the influence of daily-life dual-tasks on gait spatiotemporal variables of the older adults with PD. Methods: 20 older adults without PD and 20 older adults with PD participated in the study. Gait kinematic was analyzed under three different conditions: walking without dual task, walking carrying bags with weight, and walking talking on the cell phone. Results: Older adults with PD presented lower speed (p = . 001), cadence (p = . 039), and shorter step length (p = . 028) than older adults without PD during walking without dual tasks. When walking while carrying bags with weight, older adults with PD had a lower speed (p

1,2,3-triazolium salts are poorly understood regarding their antileishmanial activity. Hence, as an effort to identify novel chemical scaffolds as antileishmanial agents, a series of 1,2,3-triazolium salts (TS) and corresponding 1,2,3-triazole (T) precursors including new epoxide derivatives were synthesized and assayed against Leishmania amazonensis promastigote and intracellular amastigote forms. Among them, the compound TS-6 exhibited promising activity on promastigotes (IC50 = 3.61 μM) and intracellular amastigotes (IC50 = 7.61 μM) of L. amazonensis, superior to miltefosine (IC50 > 10.0 μM), used as reference drug. In addition, TS-6 showed negligible cytotoxicity on murine peritoneal macrophages with a SI of about 10. Studies on the mode of action of TS-6 indicate mitochondrial dysfunction through an increase in ‘total’ and mitochondrial-ROS as well as depolarization of mitochondrial membrane potential of L. amazonensis promastigotes. In silico physicochemical studies indicate that the TS-6 could potentially be used as an oral drug.

In this paper we aim at demonstrating the feasibility of a bilateral training protocol supported by a dual arm exoskeleton, ALEx-RS. Three subjects performed the same reaching task in three conditions: with and without the exoskeleton, and in the bilateral mode. EMG data recorded during the experimental sessions showed that ALEx-RS features a high level of transparency and all subjects easily accomplished the bilateral task in an intuitive way. These findings demonstrated the suitability of ALEx-RS for being applied in a rehabilitation protocol in which also bilateral strategies are employed.

Understanding how the central nervous system copes with the high number of degrees of freedom in the musculoskeletal system is an open challenge. A possible approach is that the CNS uses kinematics and neuromuscular synergies as neural strategies for movements to reduce the complexity of control. The present study aims at analyzing the kinematics complexity of human arm movements, and determining kinematics synergies in upper-limb movements. Four right-handed subjects executed ten tasks involving movements on three directions (contralateral, central, and ipsilateral) while sitting in front of a cardboard. A motion capture system was used to record subjects' data during each task, to evaluate angular velocities of shoulder flexion, abduction, internal rotation, and elbow flexion. The kinematics synergies were derived from tasks using Principal Component Analysis for each subject. Results showed that the first three Principal Components captured approximately 86% of the variance, and the first six PCs accounted for 96%. The synergies were then used to reconstruct each task, featuring a normalized reconstruction error of 0.28% for the first three synergies recruited. The findings of this study might provide simplified strategies for design and control of wearable artificial limbs for rehabilitation-based therapies.

Triazoles are interesting templates for novel chemotherapeutic drugs. We synthesized here 17 1,3,4-substituted-1,2,3-triazoles that differed in their 1'-substituent (variable alkyl chain lengths C3-C12), the 3'-substituent (no substituent, -methyl or -propyl) or the salt form obtained. Several of the compounds were cytotoxic (μM range) for tumor cells (HL-60, Jurkat, MCF-7, HCT-116), and when the effect was compared to non-transformed cells (Vero), selectivity ratios of up to 23-fold were obtained. To estimate the liability of these potential drug candidates for triggering neurotoxicity, we used the LUHMES cell-based NeuriTox assay. This test quantifies damage to the neurites of human neurons. The four most potent tumoricidal compounds were found to be neurotoxic in a concentration range similar to the one showing tumor cell toxicity. As the neurites of the LUHMES neurons were affected at >4-fold lower concentrations than the overall cell viability, the novel triazoles were classified as specific neurotoxicants. The structure-activity relationship (SAR) for neurotoxicity was sharply defined and correlated with the one for anti-neoplastic activity. Based on this SAR, two non-neurotoxic compounds were predicted, and testing in the NeuriTox assay confirmed this prediction. In summary, the panel of novel triazoles generated and characterized here, allowed to define structural features associated with cytotoxicity and neurotoxicity. Moreover, the study shows that potential neurotoxic side effects may be predicted early in drug development if highly sensitive test methods for neurite integrity are applied.

Tuberosity grafts had a greater percentage of lamina propria and lower percentage of submucosa when compared to lateral palate grafts. The study aims to understand the differences in the structural composition of soft tissue autografts harvested from the lateral palate or the tuberosity. Patients were randomly allocated to receive autografts harvested either from palatal or tuberosity sites to augment horizontal volume deficiencies around single-tooth implants. Tissue biopsies were analyzed for histological and histo-morphometric analysis. Picro-sirius red stain was used to evaluate collagen 1 and 3. Also, immuno-histochemical analysis was performed against MMP1, MMP2, cytokeratin-10, cytokeratin-13, and lysine hydroxylase-2. Twenty specimens were harvested from 9 subjects in the lateral palate group (PG) and 11 subjects in the tuberosity group (TG). The percentage of lamina propria represented 51.08% in the PG group and 72.79% in the TG group, while the area of submucosa was minimal in the TG group representing 4.89% of the total sample vs 25.75% in the PG. The total area of COL-1 and 3 in the TG was 1.19 ± 0.57 and 0.72 ± 0.44 mm2, respectively, while in the PG, the corresponding values were 1.4 ± 0.7 and 1.04 ± 0.5 mm2. The immuno-histochemical analysis generally showed a higher expression of LLH-2, MMP2, CYT-10, and CYT-13 in the TG when compared with the PG. Tuberosity grafts had a greater percentage of lamina propria and lower percentage of submucosa. The collagen content in the lamina propria was similar for both groups while the immuno-histochemical profile showed differences in the antibody expression of the epithelial cells. Tuberosity grafts had more lamina propria and less submocusa, which may be beneficial for volume augmentation.

Objective: Few quantitative studies have examined the effect of religious involvement on the course of bipolar disorder (BD). We investigated the effects of religious activity and coping behaviors on the course of depression, mania, and quality of life (QoL) in patients with BD. Methods: Two-year longitudinal study of 168 outpatients with BD. Linear regression was used to examine associations between religious predictors and outcome variables (manic symptoms, depression, QoL), controlling for sociodemographic variables. Results: Among the 158 patients reassessed after 2 years, positive religious coping at T1 predicted better QoL across all four domains: physical (β = 10.2, 95%CI 4.2 to 16.1), mental (β = 13.4, 95%CI 7.1 to 19.7), social (β = 10.5, 95%CI 3.6 to 17.33), and environmental (β = 11.1, 95%CI 6.2 to 16.1) at T2. Negative religious coping at T1 predicted worse mental (β = -28.1, 95%CI -52.06 to -4.2) and environmental (β = -20.4, 95%CI -39.3 to -1.6) QoL. Intrinsic religiosity at T1 predicted better environmental QoL (β = 9.56, 95%CI 2.76 to 16.36) at T2. Negative religious coping at T1 predicted manic symptoms (β = 4.1) at T2. Conclusion: Religiosity/spirituality (R/S) may influence the QoL of patients with BD over time, even among euthymic patients. Targeting R/S (especially positive and negative religious coping) in psychosocial interventions may enhance the quality of recovery in patients with BD.

Spin-valley and electronic band topological properties have been extensively explored in quantum material science, yet their coexistence has rarely been realized in stoichiometric two-dimensional (2D) materials. We theoretically predict the quantum spin Hall effect (QSHE) in the hydrofluorinated bismuth (Bi2HF) nanosheet where the hydrogen (H) and fluorine (F) atoms are functionalized on opposite sides of bismuth (Bi) atomic monolayer. Such Bi2HF nanosheet is found to be a 2D topological insulator with a giant band gap of 0.97 eV which might host room temperature QSHE. The atomistic structure of Bi2HF nanosheet is noncentrosymmetric and the spontaneous polarization arises from the hydrofluorinated morphology. The phonon spectrum and ab initio molecular dynamic (AIMD) calculations reveal that the proposed Bi2HF nanosheet is dynamically and thermally stable. The inversion symmetry breaking together with spin-orbit coupling (SOC) leads to the coupling between spin and valley in Bi2HF nanosheet. The emerging valley-dependent properties and the interplay between intrinsic dipole and SOC are investigated using first-principles calculations combined with an effective Hamiltonian model. The topological invariant of the Bi2HF nanosheet is confirmed by using Wilson loop method and the calculated helical metallic edge states are shown to host QSHE. The Bi2HF nanosheet is therefore a promising platform to realize room temperature QSHE and valley spintronics.

AIM To compare the soft tissue volume gain (VG) around single tooth implants with subepithelial connective tissue graft (SCTG) from either the lateral palate (LP) or from the tuberosity area (TA). METHODS Thirty-two patients with 36 implants with buccal volume deficiencies were randomly assigned to receive SCTG from LP (control group/CG) or TA (test group/TG). Clinical parameters were recorded. VG was evaluated by stereolithography (STL) image superimposition of two intraoral scans (baseline/BL and 3 months after surgery/FU-3). Descriptive analysis was performed for both groups, and for comparisons, Mann-Whitney U test was used. RESULTS In terms of VG values, no statistically significant differences were observed except for values at 6 and 7 mm apically to the healing abutment which favoured the TG. Mean values were 0.69 ± 0.23 mm for CG while TG obtained 0.79 ± 0.10 mm (p = .64). Regarding Keratinized tissue (KT) width statistical significant differences were found favouring TG, which obtained a gain of 0.83 ± 0.61 mm compared with 0.22 ± 0.48 mm for CG (p = .009). Pink esthetic scores resulted in mean values of 10.07 ± 2.19 for the CG, while TG obtained 9.15 ± 2.34. CONCLUSIONS Both procedures were effective in increasing soft tissue volume with no statistically significant differences. A longer follow-up is needed to confirm or refute these results.

In this work, we propose an improved version of our algorithm for real-time robotic assistance tuning in robot-based therapy with any kind of active device for upper-limb rehabilitation. In particular, the work describes in detail how to extract accurate performance indices from the subject’s execution, and how to correlate them with the amount of assistance to be correspondingly provided over time. The algorithm also aims at enhancing subject’s efforts for a more effective recovery, tailoring the therapy to the patient without prior knowledge of his/her clinical status. Finally, an assessment phase illustrates the effectiveness of the procedure, showing how the system tunes the assistance required by the subjects to perform specific tasks.

Background Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohort of patients affected by T1DM. Methods A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage ≥3 CKD (eGFR 30% from baseline was evaluated. Results The mean estimated GFR was 98 ± 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions Albuminuria and eGFR reduction represent independent risk factors for incident stage ≥3 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening. Electronic supplementary material The online version of this article (10.1186/s12882-018-1136-6) contains supplementary material, which is available to authorized users.

BackgroundInitial studies have shown that old occlusions or those with indeterminate occlusion duration have been associated with percutaneous coronary intervention (PCI) failure and a worse prognosis. This study aimed to determine the impact of occlusion duration on the success and outcomes of contemporary PCI on chronic total occlusion (CTO).MethodsThe authors analyzed a retrospective cohort of consecutive patients submitted to PCI in CTO, who were compared according to the confirmed occlusion duration (COD) < 12 months, ≥ 12 months, or indeterminate occlusion duration (IOD).ResultsA total of 168 patients were treated, 122 (72.6%) with COD (80 < 12 months, 42 ≥ 12 months) and 46 (24.7%) with an IOD. Lesion extension was 17.0 ± 13.6mm, in 2.90 ± 0.58mm vessels, and the anterograde approach was used in 98.8% of cases. Angiographic success was attained in 79.2% of patients (80.0% vs. 73.8% vs. 82.6%; p = 0.73). The main cause of failure was the inability to cross the lesion with the guidewire (68.6%). Occlusion duration had no impact on in-hospital events (4.8% vs. 7.1% vs. 6.0%; p = 0.73), which were almost entirely explained by periprocedural myocardial infarction, or on late outcomes (18.8% vs. 7.1% vs. 15.3%; p = 0.23). At the multivariate analysis, lesion length ≥ 20mm (odds ratio - OR = 7.27; 95% confidence interval - 95% IC 1.94-29.1; p = 0.003), calcification (OR = 4.72; 95% CI 1.19-19.1; p = 0.02), and tortuosity of the occluded segment (OR = 15.98; 95% CI 2.18-144.7; p = 0.007) were predictors of failure.ConclusionsOcclusion duration was not associated with increased failure rate of the procedure or worse PCI outcomes in CTO.

Mycotic aneurysm of the hepatic artery (HA) is a rare, unpredictable, and potentially lethal complication of liver transplantation (LT). Pediatric LT is not exempt from it but the related literature is rather scanty. We present our experience with post-LT mycotic aneurysm of the HA in pediatric age, describing four cases occurred with a special focus on the possible risk factors for its development and a proposal for the management of high-risk recipients.